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Individual

SHANNON OPEL SWIFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2301 S ONEIDA ST, ASHWAUBENON, WI 54304-5230
(920) 497-7783
(920) 497-7789
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3632
WI
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100047539
WI
01
K400239771
MEDICARE PTAN
WI
Enumeration date
06/15/2015
Last updated
08/28/2024
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